JP2023525586A - tendon fixation plate - Google Patents

Abstract

An implant IM for planar connection of tissue to bone, the implant IM comprising a clamping surface 1, the clamping surface 1 comprising a lateral edge 3 and a medial edge 4, the lateral edge 3 , at least partially connected to the inner edge 4 by at least one connecting web 5 and/or the clamping surface 1 is at least partially connected to the outer edge 3 and at least one , which are connected by at least one connecting web 5 to at least a partial region of the outer edge 4 of the clamping surface 1. The clamping surface 1 has a circular, elliptical or polygonal perimeter, in particular a profile with rotational and/or mirror symmetry, and the clamping surface 1 has an opening 7', 7'', the openings 7', 7'' being designed to receive the mounting means 2', the mounting means 2' comprising the pin 10, the head 8 and the neck. 9 and . [Selection drawing] Fig. 1

Description

Detailed description of the invention

The present invention relates to an implant for planar connection of tissue to bone according to the preamble of claim 1 .

Medical intervention to fix and reconstruct torn tissue, such as tendon tissue, is a routine procedure and can have a variety of reasons. In this respect, it is known from the prior art, for example, to fix torn tendon tissue to the bone by means of implants for bonding onto the bone in order to reconstruct the torn tendon. Among other things, the presence of sufficient blood flow through the tendon tissue must be ensured here in order to prevent a necrotic course.

Implants of this type are known, for example, from EP 3 184 078 B1. Here, the torn tendon tissue is permanently fixed to the bone by means of a clamping surface with through holes and at least three mounting means connected thereto. The implant is held for fixation purposes by means of a special instrument, and the mounting means are driven into the bone, for example by an impact instrument. The tissue is thereby connected to and pressed onto the bone in a planar manner.

A disadvantage of this is, inter alia, that for secure retention, the implantation of the implant with its mounting means into the bone must be carried out with very high precision. The position, angle and orientation in which the implant is installed must be carefully selected, which makes such surgical interventions more time consuming and therefore more costly. means that it entails

Additionally, inaccurate driving of the implant into the bone can affect the stability of the implant and can dislodge tissue from the bone. As a result, another intervention is required, which places additional stress on the patient.

Also, minimally invasive surgical introduction of implants is often not possible due to their considerable size.

It is therefore an object of the present invention to minimize the necrotic course while at the same time reducing the tissue in a surgical intervention that can be performed stably and more easily with less expense in terms of time and cost. It is to allow it to be anchored to the bone.

According to the present invention, this object is achieved by the characterizing part of claim 1 together with the preamble of claim 1 . The dependent claims specify advantageous and expedient developments.

To this end, an implant has been proposed for planar connection of tissue to bone, the clamping surface comprising a lateral edge and a medial edge, the lateral edge being at least partially bounded by at least one is at least partially connected to the inner edge by a connecting web and/or the clamping surface comprises an outer edge and at least one opening arranged in the clamping surface, the opening is connected by at least one connecting web to at least a partial region of the outer edge of the clamping surface.

According to the invention, it is provided here that the clamping surface has a circular, elliptical or polygonal perimeter, in particular a contour with rotational and/or mirror symmetry. , the clamping surface has a further opening, the further opening being designed to receive mounting means, the mounting means comprising a pin, a head and a neck. .

This makes it possible to take advantage of the maximum support or clamping surface and symmetry of the implant for installation without uneven conditions occurring in the contact pressure, e.g. in separate corner areas. can be In addition, this shaping of the implant allows it to be manipulated by minimally invasive instruments and can be introduced and positioned via corresponding devices, thus permitting minimally invasive surgery. offers the possibility of use in the area of

The mounting means can be optimally adapted in their interaction with the clamping surface and the bone. In addition, the mounting means can be driven into the bone by means of special instruments, eg screwdrivers or impact adapters.

Also, the implant can be subjected to continuous contact pressure and this contact pressure can be maintained throughout the period of bonding. Within this range, more rapid binding may be possible.

As a result, the time spent required for surgical intervention can be significantly reduced and the healing course can be shortened. Advantageously, therefore, follow-up treatment can be considerably facilitated, so that the duration of treatment after surgical intervention and also treatment costs can be reduced. This may reduce or even eliminate the need for treatment that may occur after the introduction of the implant or after the tissue-bone connection.

Furthermore, it is provided that a further opening in the clamping surface is centered.

This allows for optimal alignment and positioning of the implant at the desired site, facilitating interventions associated therewith. Thus, it becomes possible to anchor the implant to the bone, for example in different orientations, which means less time spent and greater flexibility for the surgeon, although it may be easier for the intervention to be performed. This is because the optimal alignment can be found more quickly.

In addition, it is provided that the further opening has a cavity for receiving the head with a form fit.

This allows a uniform and faster installation of the clamping surface into the bone. Thereby, it is possible to connect the head of the mounting means to the implant by means of a form-fitting, defined retention and defined alignment between the mounting means and the implant as well for this purpose. without the need for further measures for

Furthermore, it is provided that the neck and head form a joint with the opening, in particular a joint in the manner of a wobble joint.

This allows the clamping surface to assume different position angles with respect to the mounting means. The clamping surface is thus flexibly connected to the mounting means to facilitate crimping onto the bone.

This is done by slanting the clamping surface with respect to the bone, which allows greater flexibility in implant introduction direction and tissue fixation.

It also allows for optimal support of the clamping surfaces while also allowing for bony non-flatness and anatomical differences to be counteracted. As a result, there is greater flexibility in choosing the mounting point for the implant, and the mounting point can be selected in the best possible manner.

In addition, the joint aligns the clamping surface with respect to the axis defined by the longitudinal axis of the pin between 0° and 65°, in particular between 0° and 55°, preferably between 0° and 45°. , particularly preferably between 0° and 20°.

As a result, the inclination of the clamping surface with respect to the longitudinal axis of the pin is limited, creating a solid angle in which the tendon clamping surface provides firstly optimal retention and secondly introduction. and flexibility required for installation.

In addition, it is provided that the further opening in the clamping surface is eccentric.

This gives the surgeon the possibility to choose the position of the clamping surface relative to the mounting means and the tendon to be fixed, which provides flexibility when looking for a suitable site for introduction of the implant. can allow for increased sexuality.

Further, it is provided that the clamping surface comprises at least one protrusion, the protrusion being offset with respect to the clamping surface, the protrusion having at least one opening. , the opening in the projection is designed to receive the mounting means and the further opening in the projection is designed as a cutout.

As a result, additional possibilities for installing implants can be obtained. Also, the introduction of implants during surgical intervention can be simplified. For example, additional anchoring means can be used that are placed in openings in the projection and connect tissue and bone to each other. It may also allow for tissue anchorage and, additionally, bone anchorage of the implant. In addition, the cutouts can facilitate blood flow and oxygenation to the tendon, thus facilitating the healing process.

Further, it is provided that the clamping surface comprises at least two opposite spikes, which are formed on the underside of the clamping surface and/or which preferably has a return.

The spikes can provide additional installation possibilities, for example pre-installation of the implant. In addition, the spikes can be designed to prevent too deep driving of the mounting means and consequent excessive contact pressure on the clamping surfaces. The spikes thereby allow introduction of the implant in a more rapid and reliable manner.

Furthermore, it is provided that the pin is provided with a thread.

By this means it is possible to allow a secure and, if necessary, releasable retention of the mounting means.

In addition, it is provided that the pin is configured in the form of a sleeve, in particular in the manner of a drive sleeve, and/or that the pin is provided with barbs.

By this means, the introduction of the mounting means into the bone can be made possible with a suitable instrument, eg a hard impact instrument.

Furthermore, it is provided that the clamping surface comprises a plurality of fixing means, which are formed on the underside of the clamping surface, in particular perpendicular to the clamping surface.

The fixation means provide the tendon with additional retention on the bone. The tendon is held between the clamp surface and the bone. Due to the fact that the above-mentioned circular, elliptical or polygonal, especially rotationally symmetric, shaping offers more possibilities for the orientation of the implant, the fixation means can be It must be possible to engage the tendon at all times.

The vertical configuration of the fixation means makes it possible to ensure flexibility during implant use and stability during tendon fixation. The fixation means prevent slippage of the tissue, eg the tendon, and provide a firm and stable hold of the tendon with slight contact pressure on the clamping surfaces. It is thereby possible to allow more rapid binding and avoid necrotic processes.

In addition, the fixing means are integrally formed of the same material on the clamping surface and/or the fixing means are conical and/or the fixing means have a high areal density. is stipulated.

This ensures a stable connection between the fixation means and the clamping surface, which supports a secure retention of the tendon on the bone. In addition, it allows a simple fabrication of the implant, which improves the outlay on costs for fabrication and thus for surgical intervention.

It may be provided that at least the clamping surface and the fixing means are manufactured from plastic, in particular biocompatible plastic. First, such materials are sufficiently stable to connect tissue and bone together. Second, this type of material is readily conformable to the human body.

The conical shape allows rapid penetration of the fixation means into the tendon. By this means the tendon can be more easily retained by the implant and can speed up the introduction of the implant during surgical intervention. This allows for savings in terms of time and costs.

Due to the fact that the areal density of the fixing means is high, the underside of the clamping surface is evenly provided with mutually spaced fixing means, so as to provide the best possible adhesion to the tendon. Ensures surface adhesion. This ensures an increased engagement surface of the implant in relation to the tissue to be fixed, eg the tendon. The high number over the entire underside of the clamping surface allows for increased implant anchoring action and reduced contact pressure. In addition, it prevents slippage of tissues, such as tendons.

Furthermore, the securing means are formed with a length greater than 2 millimeters, preferably between 2 and 6 millimeters, and/or the length of the securing means is increasing towards the outer edge of the clamping surface.

These lengths are particularly advantageous for anchoring tissue such as tendons, especially tendons in the human shoulder region. A certain length of the fixation means, which penetrates the tissue and is then supported on the bone, prevents excessive contact pressure on the implant and particularly ensures that the tissue remains on the bone. And it is guaranteed to be stably fixed.

A longer fixing means at the outer edge of the clamping surface makes it possible to counteract differences in contact pressure due to centering of the mounting means. This ensures improved properties in tendon fixation.

This makes it possible to take into account also individual anatomical situations and unevenness of the bones. As a result, introduction of an implant or connection between tissue and bone can be simplified and expedited. Also, increased stability of tissue and bone retention can be achieved. Furthermore, a more uniform compression of the tissue over the area of the clamping surface can thereby be achieved.

In addition, the at least two mounting means are arranged substantially parallel to each other and/or have different lengths and/or the clamping surfaces form planes; is defined, wherein the at least one mounting means is arranged substantially perpendicular to the plane and/or the at least one mounting means is arranged substantially parallel to the plane.

Individual anatomical situations can be taken into account by different designs and arrangements of the mounting means. This can result in less time spent on surgical intervention. Furthermore, this can result in improved retention of the implant and, associated therewith, a secure connection between tissue and bone.

Further, it is provided that the clamping surface comprises an instrument engaging surface and/or an instrument engaging opening, the engaging surface being free of fixing means.

A stable grasp of the implant for anchoring the implant in the bone allows for a time-saving and safe surgical intervention. The position and orientation are preferably precisely selected by form-fitting engagement, especially from the field of minimally invasive surgery, e.g. with special instruments, e.g. forceps holders with internal instrument feedthroughs can do.

The absence of fixing means on the mating surfaces is advantageous as it allows for easier formation of the device and more secure retention of the implant. Thereby the introduction of implants during surgical intervention can be simplified and expedited.

Additionally, the at least one projection is arranged substantially along the lateral extent of the clamping surface and/or the at least one projection and the clamping surface are formed as one piece. It is stipulated that

This increases the possibility of anchoring the implant, for example in bone. This may allow the connection between tissue and bone to withstand increased loading after introduction of the implant. Therefore, treatment after tissue and bone connection by implants may be unnecessary.

Furthermore, it is provided that the clamping surface has at least partially rounded edges and/or is at least partially curved.

It is thus possible to take individual anatomical situations into account. This allows for simpler and faster introduction of implants or tissue-to-bone connections. Also, it is possible to achieve stable retention of tissue and bone. This also achieves a more uniform compression of the tissue over the surface area of the clamping surface. A clamping surface with a curved shape has the advantage of allowing easy modeling of the implant relative to the bone.

In the context of the invention, the fixing means can also be designed as spikes or small teeth.

Furthermore, in the context of the present invention, the mounting means can also be designed and understood as screws, nails or bone anchors. An installation means of this kind can be produced cost-effectively and allows a stable connection between the bone and the implant.

In addition, in the context of the present invention, an impact sleeve can be understood as meaning a sleeve with a conical tip, the tip of the sleeve into the object to be fixed, e.g. a bone. Simplify penetration.

Further details of the invention are described in the drawings by reference to schematically illustrated exemplary embodiments.

In the drawing:

1 shows a perspective view of an implant according to the invention with screws as mounting means; FIG. Figure 2 shows a top view of an implant according to the invention with the visible heads of the screws; Fig. 3 shows a perspective view of an implant according to the invention having a projection and two mounting means;

FIG. 1 shows a perspective view of an implant IM for planar connection of tissue to bone according to the invention. It comprises a clamping surface 1 by means of which tissue, eg tendon tissue, is fixed and held in order to be bonded onto the bone. The clamping surface 1 comprises an outer edge 3 and an inner edge 4 , the outer edge 3 being connected to the inner edge 4 by a connecting web 5 . An opening 14 is further arranged in the clamping surface 1 , the opening 14 being surrounded by the connecting web 5 and the outer edge 3 of the clamping surface 1 . The opening 14 allows sufficient blood flow to the tendon tissue to obtain a healing process. At the same time, necrotic processes can thereby be prevented, since the clamping surface 1 rests on the tendon in a planar fashion, avoiding contact pressure peaks.

The clamping surface 1 forms a plane and is formed with a circular perimeter in the exemplary embodiment shown in FIG. In particular, the clamping surface 1 can, according to the invention, also be formed with elliptical, polygonal, rotationally symmetric and/or mirror symmetrical contours. Such a shape allows the clamping surface 1 to support the tendon over a large surface area and allows the contact pressure to be evenly distributed.

The clamping surface 1 has a centrally located opening 7'. The opening 7' is designed to receive the mounting means 2'. The implant IM can be stably and reliably anchored to the bone by the anchoring means 2'.

In this exemplary embodiment, the mounting means 2' are designed as a screw 11 with a pin 10 in the form of a thread, a head 8 (illustrated in FIG. 2) and a neck 9. . The screw 11 offers the advantage of being able to determine the depth of penetration into the bone due to its rotational movement. This provides the possibility of optimally adjusting the contact pressure of the clamping surface against the tissue to be fixed, eg the tendon. Firstly, moreover, an excessively deep installation of the implant IM can lead to excessive contact pressure, which can be corrected by inversion, and secondly, subsequent removal of the implant IM can lead to screw 11 made possible by The screw 11 can also be anchored in the bone by dowels, which can result in improved retention in the bone.

Neck 9 and head 8 (illustrated in FIG. 2) form a joint in the manner of a wobble joint, together with a centrally located opening 7', so that the clamping surfaces The position of 1 can be slanted with respect to the longitudinal axis 12 of the pin during installation of the implant IM. This allows for optimal tissue support and fixation and allows the implant IM to be flexibly adapted to the anatomical situation.

Fixation means exemplified by 6', 6'', 6'''', 6'''' are also shown, which enable the fixation of tissue, for example tendon tissue. simplifies the connection or fastening of tissue, such as tendon tissue, to bone and strengthens the connection between tissue and bone. Fixing means 6 ′, 6 ″, 6 ″, 6 ″″ are formed on the underside of the clamping surface 1 . As a result, tissue can be held between the clamping surface 1 and the bone.

The fixing means 6', 6'', 6'''', 6'''' are formed perpendicular to the clamping surface 1, so that the implant IM is A stable and reliable hold can be provided. The fixation means 1 are conically shaped so that they penetrate in a simple manner into the tissue to be fixed and thus allow a simplified mounting of the implant IM.

The fixing means 6', 6'', 6''', 6'''' are integrally formed on the clamping surface 1 of the same material, so that the fixing means 6', 6'', 6 There is a stable connection between the '''', 6'''' and the clamping surface 1, allowing the implant IM to be manufactured simply and quickly.

The fixation means 6', 6'', 6''', 6'''' can produce an improved and uniform hold on the tissue due to their high areal density on the underside of the clamping surface 1. FIG. The length of the fixing means 6', 6'', 6''', 6'''' is designed to be greater than 2 millimeters, preferably between 2 and 6 millimeters long. It allows optimal retention of tissue, for example the human shoulder tendon.

FIG. 2 shows a top view of the embodiment variant shown in FIG. 1 of an implant IM with an outer edge 3 and an inner edge 4 . The circular perimeter of the clamping surface 1 allows its use for minimally invasive surgical interventions. In this top view of FIG. 2, the head 8 of the mounting means hides the opening 7 (not visible) of the implant IM.

The mounting means 2' are here designed as screws 11, which can be screwed into the bone using suitable special tools. This allows quick and easy introduction of the implant. At the same time, by screwing in the screw 11, the contact pressure of the clamping surface 1 against the tissue to be fixed can be flexibly changed and adjusted. The clamping surface 1 is perforated by means of connecting webs 5 and openings 14, also shown in FIG. blood flow, and the necrotic course is prevented.

Via the connecting web 5, a suitable holding or grasping device is possible to hold and optimally guide the implant IM during the surgical intervention. As a result, the implant can be introduced and anchored at a specific site within the bone.

FIG. 3 shows an embodiment variant of the implant IM with protrusions 15 in a perspective view from the underside of the implant. An implant IM for planar connection of tissue to bone comprises a clamping surface 1 with a lateral edge 3 and a medial edge 4 . The outer edge 3 is connected to the inner edge 4 by a connecting web 5 and the clamping surface 1 is provided with openings 14, 7'' arranged in the clamping surface 1, the openings 7'' being , is connected by a connecting web 5 to a partial area of the outer edge 3 .

The clamping surface 1 has an elliptical contour and a further opening 7'' is formed eccentrically in the clamping surface 1 for receiving the mounting means 2'. By this means it is possible to select the optimal position of the implant IM with respect to the tendon and the mounting means 2'. The mounting means 2 ′ comprise a pin 10 , a head 8 (not visible in this view) and a neck 9 .

The clamping surface 1 comprises a projection 15 which is offset with respect to the clamping surface 1, the projection 15 having openings 16, 19, the opening 19 in this projection being adapted for mounting means. 2″, the further opening 16 in this projection is designed as a cutout. The projections 15 are arranged along the lateral extent of the clamping surface 1 and are formed in one piece with the clamping surface 1 . In the interaction of the eccentrically arranged opening 7'' of the clamping surface 1 and the mounting means 2' a simple and rapid fixation of the implant IM to the bone is possible. A further opening 16 in this protrusion is designed as a cutout, allowing only a very small contact surface of the protrusion 15 to the tissue, the tissue being partially covered by the protrusion 15, thereby Additional openings 16 can positively affect oxygen supply or improve blood flow. Due to the fact that the projections 15 are offset, it is possible to prevent excessive contact pressure and consequent necrotic effects of the clamping surface 1 on the tendons to be held by the clamping surface 1. can.

FIG. 3 also shows that the clamping surface has two opposite spikes 17', 17'' formed on its underside, which spikes 17', 17'' , with returns. The pin 10 of the mounting means 2', 2'' is constructed in the form of a sleeve, in the manner of a drive sleeve, and is likewise provided with barbs. This type of shaping allows a simple driving of the mounting means 2'' into the bone and a mounting of the mounting means against inadvertent detachment.

Furthermore, FIG. 3 illustrates that the clamping surface is provided with a plurality of fastening means 6′, 6″, 6″″, 6″″, these fastening means being , is integrally formed of the same material under the clamping surface 1, perpendicular to the clamping surface 1, and has a conical shape and a high areal density.

Furthermore, the mounting means of the clamping surface 1 and the mounting means 2'' of the projection are arranged parallel to each other and have different lengths, and that the clamping surface 1 forms a plane. , the mounting means 2' of the clamping surface are arranged perpendicularly to said plane.

List of reference signs:
IM... Implant, 1... Clamping surface, 2'... Mounting means (clamping surface), 2''... Mounting means (protrusion), 3... Edge (outer), 4... Edge (inner), 5... Connecting web, 6' to 6''''... fixing means, 7'... opening (center), 7''... opening (eccentric), 8... head, 9... neck, 10... pin, 11... screw, 12 ... longitudinal axis of the pin, 14 ... opening, 15 ... projection, 16 ... opening (further projection), 17', 17'' ... spike, 18 ... instrument engaging opening, 19 ... opening ( protrusion).

Detailed description of the invention

The present invention relates to an implant for planar connection of tissue to bone according to the preamble of claim 1 .

Medical intervention to fix and reconstruct torn tissue, such as tendon tissue, is a routine procedure and can have a variety of reasons. In this respect, it is known from the prior art, for example, to fix torn tendon tissue to the bone by means of implants for bonding onto the bone in order to reconstruct the torn tendon. Among other things, the presence of sufficient blood flow through the tendon tissue must be ensured here in order to prevent a necrotic course.

Implants of this type are known, for example, from EP 3 184 078 B1. Here, the torn tendon tissue is permanently fixed to the bone by means of a clamping surface with through holes and at least three mounting means connected thereto. The implant is held for fixation purposes by means of a special instrument, and the mounting means are driven into the bone, for example by an impact instrument. The tissue is thereby connected to and pressed onto the bone in a planar manner.

A disadvantage of this is, inter alia, that for secure retention, the implantation of the implant with its mounting means into the bone must be carried out with very high precision. The position, angle and orientation in which the implant is installed must be carefully selected, which makes such surgical interventions more time consuming and therefore more costly. means that it entails

Additionally, inaccurate driving of the implant into the bone can affect the stability of the implant and can dislodge tissue from the bone. As a result, another intervention is required, which places additional stress on the patient.

Also, minimally invasive surgical introduction of implants is often not possible due to their considerable size.
Furthermore, WO 2019/157853 A1 describes a fixation clamp for knee joint surgery for fixing the collateral ligaments of the knee joint or for preventing damage to the patellar tendon at the tibial tubercle (Tuberculum tibialis). disclosed.
Furthermore, EP 0 358 372 A1 comprises a channel-shaped section made of a material suitable for human implantation and having upstanding, spaced parallel spikes. A grooved ligament clamp is disclosed.
Further, US 2007/118128 A1 discloses various exemplary methods and devices for anchoring implants to natural tissue, such as bone.
Furthermore, US 2013/096678 A1 discloses an implant fixation mechanism comprising a base element, a compression element and a fastening element.
Further, US 2016/242771 A1 discloses a bone fixation device or bone clamp comprising a crown portion, an engagement portion and a lateral edge generally defined between the crown portion and the engagement portion. are doing.

It is therefore an object of the present invention to minimize the necrotic course while at the same time reducing the tissue in a surgical intervention that can be performed stably and more easily with less expense in terms of time and cost. It is to allow it to be anchored to the bone.

According to the present invention, this object is achieved by the characterizing part of claim 1 together with the preamble of claim 1 . The dependent claims specify advantageous and expedient developments.

To this end, an implant has been proposed for planar connection of tissue to bone, the clamping surface comprising a lateral edge and a medial edge, the lateral edge being at least partially bounded by at least one is at least partially connected to the inner edge by a connecting web and/or the clamping surface comprises an outer edge and at least one opening arranged in the clamping surface, the opening is connected by at least one connecting web to at least a partial region of the outer edge of the clamping surface.

It is provided here that the clamping surface has a circular, elliptical or polygonal perimeter, in particular a contour with rotational and/or mirror symmetry, said clamping surface has a further opening, the further opening being designed to receive mounting means, the mounting means comprising a pin, a head and a neck.

This makes it possible to take advantage of the maximum support or clamping surface and symmetry of the implant for installation without uneven conditions occurring in the contact pressure, e.g. in separate corner areas. can be In addition, this shaping of the implant allows it to be manipulated by minimally invasive instruments and can be introduced and positioned via corresponding devices, thus permitting minimally invasive surgery. offers the possibility of use in the area of

The mounting means can be optimally adapted in their interaction with the clamping surface and the bone. In addition, the mounting means can be driven into the bone by means of special instruments, eg screwdrivers or impact adapters.

Also, the implant can be subjected to continuous contact pressure and this contact pressure can be maintained throughout the period of bonding. Within this range, more rapid binding may be possible.

As a result, the time spent required for surgical intervention can be significantly reduced and the healing course can be shortened. Advantageously, therefore, follow-up treatment can be considerably facilitated, so that the duration of treatment after surgical intervention and also treatment costs can be reduced. This may reduce or even eliminate the need for treatment that may occur after the introduction of the implant or after the tissue-bone connection.

Furthermore, it is provided that a further opening in the clamping surface is centered.

This allows for optimal alignment and positioning of the implant at the desired site, facilitating interventions associated therewith. Thus, it becomes possible to anchor the implant to the bone, for example in different orientations, which means less time spent and greater flexibility for the surgeon, although it may be easier for the intervention to be performed. This is because the optimal alignment can be found more quickly.

In addition, it is provided that the further opening has a cavity for receiving the head with a form fit.

This allows a uniform and faster installation of the clamping surface into the bone. Thereby, it is possible to connect the head of the mounting means to the implant by means of a form-fitting, defined retention and defined alignment between the mounting means and the implant as well for this purpose. without the need for further measures for

Furthermore, it is provided that the neck and head form a joint with the opening, in particular a joint in the manner of a wobble joint.

This allows the clamping surface to assume different position angles with respect to the mounting means. The clamping surface is thus flexibly connected to the mounting means to facilitate crimping onto the bone.

This is done by slanting the clamping surface with respect to the bone, which allows greater flexibility in implant introduction direction and tissue fixation.

It also allows for optimal support of the clamping surfaces while also allowing for bony non-flatness and anatomical differences to be counteracted. As a result, there is greater flexibility in choosing the mounting point for the implant, and the mounting point can be selected in the best possible manner.

In addition, the joint aligns the clamping surface with respect to the axis defined by the longitudinal axis of the pin between 0° and 65°, in particular between 0° and 55°, preferably between 0° and 45°. , particularly preferably between 0° and 20°.

As a result, the inclination of the clamping surface with respect to the longitudinal axis of the pin is limited, creating a solid angle in which the tendon clamping surface provides firstly optimal retention and secondly introduction. and flexibility required for installation.

In addition, it is provided that the further opening in the clamping surface is eccentric.

This gives the surgeon the possibility to choose the position of the clamping surface relative to the mounting means and the tendon to be fixed, which provides flexibility when looking for a suitable site for introduction of the implant. can allow for increased sexuality.

Further, it is provided that the clamping surface comprises at least one protrusion, the protrusion being offset with respect to the clamping surface, the protrusion having at least one opening. , the opening in the projection is designed to receive the mounting means and the further opening in the projection is designed as a cutout.

As a result, additional possibilities for installing implants can be obtained. Also, the introduction of implants during surgical intervention can be simplified. For example, additional anchoring means can be used that are placed in openings in the projection and connect tissue and bone to each other. It may also allow for tissue anchorage and, additionally, bone anchorage of the implant. In addition, the cutouts can facilitate blood flow and oxygenation to the tendon, thus facilitating the healing process.

Further, it is provided that the clamping surface comprises at least two opposite spikes, which are formed on the underside of the clamping surface and/or which preferably has a return.

The spikes can provide additional installation possibilities, for example pre-installation of the implant. In addition, the spikes can be designed to prevent too deep driving of the mounting means and consequent excessive contact pressure on the clamping surfaces. The spikes thereby allow introduction of the implant in a more rapid and reliable manner.

Furthermore, it is provided that the pin is provided with a thread.

By this means it is possible to allow a secure and, if necessary, releasable retention of the mounting means.

In addition, it is provided that the pin is configured in the form of a sleeve, in particular in the manner of a drive sleeve, and/or that the pin is provided with barbs.

By this means, the introduction of the mounting means into the bone can be made possible with a suitable instrument, eg a hard impact instrument.

Furthermore, it is provided that the clamping surface comprises a plurality of fixing means, which are formed on the underside of the clamping surface, in particular perpendicular to the clamping surface.

The fixation means provide the tendon with additional retention on the bone. The tendon is held between the clamp surface and the bone. Due to the fact that the above-mentioned circular, elliptical or polygonal, especially rotationally symmetric, shaping offers more possibilities for the orientation of the implant, the fixation means can be It must be possible to engage the tendon at all times.

The vertical configuration of the fixation means makes it possible to ensure flexibility during implant use and stability during tendon fixation. The fixation means prevent slippage of the tissue, eg the tendon, and provide a firm and stable hold of the tendon with slight contact pressure on the clamping surfaces. It is thereby possible to allow more rapid binding and avoid necrotic processes.

In addition, the fixing means are integrally formed of the same material on the clamping surface and/or the fixing means are conical and/or the fixing means have a high areal density. is stipulated.

This ensures a stable connection between the fixation means and the clamping surface, which supports a secure retention of the tendon on the bone. In addition, it allows a simple fabrication of the implant, which improves the outlay on costs for fabrication and thus for surgical intervention.

It may be provided that at least the clamping surface and the fixing means are manufactured from plastic, in particular biocompatible plastic. First, such materials are sufficiently stable to connect tissue and bone together. Second, this type of material is readily conformable to the human body.

The conical shape allows rapid penetration of the fixation means into the tendon. By this means the tendon can be more easily retained by the implant and can speed up the introduction of the implant during surgical intervention. This allows for savings in terms of time and costs.

Due to the fact that the areal density of the fixing means is high, the underside of the clamping surface is evenly provided with mutually spaced fixing means, so as to provide the best possible adhesion to the tendon. Ensures surface adhesion. This ensures an increased engagement surface of the implant in relation to the tissue to be fixed, eg the tendon. The high number over the entire underside of the clamping surface allows for increased implant anchoring action and reduced contact pressure. In addition, it prevents slippage of tissues, such as tendons.

Furthermore, the securing means are formed with a length greater than 2 millimeters, preferably between 2 and 6 millimeters, and/or the length of the securing means is increasing towards the outer edge of the clamping surface.

These lengths are particularly advantageous for anchoring tissue such as tendons, especially tendons in the human shoulder region. A certain length of the fixation means, which penetrates the tissue and is then supported on the bone, prevents excessive contact pressure on the implant and particularly ensures that the tissue remains on the bone. And it is guaranteed to be stably fixed.

A longer fixing means at the outer edge of the clamping surface makes it possible to counteract differences in contact pressure due to centering of the mounting means. This ensures improved properties in tendon fixation.

This makes it possible to take into account also individual anatomical situations and unevenness of the bones. As a result, introduction of an implant or connection between tissue and bone can be simplified and expedited. Also, increased stability of tissue and bone retention can be achieved. Furthermore, a more uniform compression of the tissue over the area of the clamping surface can thereby be achieved.

In addition, the at least two mounting means are arranged substantially parallel to each other and/or have different lengths and/or the clamping surfaces form planes; is defined, wherein the at least one mounting means is arranged substantially perpendicular to the plane and/or the at least one mounting means is arranged substantially parallel to the plane.

Individual anatomical situations can be taken into account by different designs and arrangements of the mounting means. This can result in less time spent on surgical intervention. Furthermore, this can result in improved retention of the implant and, associated therewith, a secure connection between tissue and bone.

Further, it is provided that the clamping surface comprises an instrument engaging surface and/or an instrument engaging opening, the engaging surface being free of fixing means.

A stable grasp of the implant for anchoring the implant in the bone allows for a time-saving and safe surgical intervention. The position and orientation are preferably precisely selected by form-fitting engagement, especially from the field of minimally invasive surgery, e.g. with special instruments, e.g. forceps holders with internal instrument feedthroughs can do.

The absence of fixing means on the mating surfaces is advantageous as it allows for easier formation of the device and more secure retention of the implant. Thereby the introduction of implants during surgical intervention can be simplified and expedited.

Additionally, the at least one projection is arranged substantially along the lateral extent of the clamping surface and/or the at least one projection and the clamping surface are formed as one piece. It is stipulated that

This increases the possibility of anchoring the implant, for example in bone. This may allow the connection between tissue and bone to withstand increased loading after introduction of the implant. Therefore, treatment after tissue and bone connection by implants may be unnecessary.

Furthermore, it is provided that the clamping surface has at least partially rounded edges and/or is at least partially curved.

It is thus possible to take individual anatomical situations into account. This allows for simpler and faster introduction of implants or tissue-to-bone connections. Also, it is possible to achieve stable retention of tissue and bone. This also achieves a more uniform compression of the tissue over the surface area of the clamping surface. A clamping surface with a curved shape has the advantage of allowing easy modeling of the implant relative to the bone.

In the context of the invention, the fixing means can also be designed as spikes or small teeth.

Furthermore, in the context of the present invention, the mounting means can also be designed and understood as screws, nails or bone anchors. An installation means of this kind can be produced cost-effectively and allows a stable connection between the bone and the implant.

In addition, in the context of the present invention, an impact sleeve can be understood as meaning a sleeve with a conical tip, the tip of the sleeve into the object to be fixed, e.g. a bone. Simplify penetration.

Further details of the invention are described in the drawings by reference to schematically illustrated exemplary embodiments.

In the drawing:

Fig. 4 shows a perspective view of an implant in a non-inventive embodiment having screws as mounting means; Fig. 3 shows a top view of an implant in an embodiment not belonging to the invention, with the screw heads visible; Fig. 3 shows a perspective view of an implant according to the invention having a projection and two mounting means;

FIG. 1 shows a perspective view of an implant IM for planar connection of tissue to bone in an embodiment not belonging to the invention. It comprises a clamping surface 1 by means of which tissue, eg tendon tissue, is fixed and held in order to be bonded onto the bone. The clamping surface 1 comprises an outer edge 3 and an inner edge 4 , the outer edge 3 being connected to the inner edge 4 by a connecting web 5 . An opening 14 is further arranged in the clamping surface 1 , the opening 14 being surrounded by the connecting web 5 and the outer edge 3 of the clamping surface 1 . The opening 14 allows sufficient blood flow to the tendon tissue to obtain a healing process. At the same time, necrotic processes can thereby be prevented, since the clamping surface 1 rests on the tendon in a planar fashion, avoiding contact pressure peaks.

The clamping surface 1 forms a plane and is formed with a circular perimeter in the exemplary embodiment shown in FIG. In particular, the clamping surface 1 can also be formed with elliptical , polygonal, rotationally symmetric and/or mirror symmetrical contours. Such a shape allows the clamping surface 1 to support the tendon over a large surface area and allows the contact pressure to be evenly distributed.

The clamping surface 1 has a centrally located opening 7'. The opening 7' is designed to receive the mounting means 2'. The implant IM can be stably and reliably anchored to the bone by the anchoring means 2'.

In this exemplary embodiment, the mounting means 2' are designed as a screw 11 with a pin 10 in the form of a thread, a head 8 (illustrated in FIG. 2) and a neck 9. . The screw 11 offers the advantage of being able to determine the depth of penetration into the bone due to its rotational movement. This provides the possibility of optimally adjusting the contact pressure of the clamping surface against the tissue to be fixed, eg the tendon. Firstly, moreover, an excessively deep installation of the implant IM can lead to excessive contact pressure, which can be corrected by inversion, and secondly, subsequent removal of the implant IM can lead to screw 11 made possible by The screw 11 can also be anchored in the bone by dowels, which can result in improved retention in the bone.

Neck 9 and head 8 (illustrated in FIG. 2) form a joint in the manner of a wobble joint, together with a centrally located opening 7', so that the clamping surfaces The position of 1 can be slanted with respect to the longitudinal axis 12 of the pin during installation of the implant IM. This allows for optimal tissue support and fixation and allows the implant IM to be flexibly adapted to the anatomical situation.

Fixation means exemplified by 6', 6'', 6'''', 6'''' are also shown, which enable the fixation of tissue, for example tendon tissue. simplifies the connection or fastening of tissue, such as tendon tissue, to bone and strengthens the connection between tissue and bone. Fixing means 6 ′, 6 ″, 6 ″, 6 ″″ are formed on the underside of the clamping surface 1 . As a result, tissue can be held between the clamping surface 1 and the bone.

The fixing means 6', 6'', 6'''', 6'''' are formed perpendicular to the clamping surface 1, so that the implant IM is A stable and reliable hold can be provided. The fixation means 1 are conically shaped so that they penetrate in a simple manner into the tissue to be fixed and thus allow a simplified mounting of the implant IM.

The fixing means 6', 6'', 6''', 6'''' are integrally formed on the clamping surface 1 of the same material, so that the fixing means 6', 6'', 6 There is a stable connection between the '''', 6'''' and the clamping surface 1, allowing the implant IM to be manufactured simply and quickly.

The fixation means 6', 6'', 6''', 6'''' can produce an improved and uniform hold on the tissue due to their high areal density on the underside of the clamping surface 1. FIG. The length of the fixing means 6', 6'', 6''', 6'''' is designed to be greater than 2 millimeters, preferably between 2 and 6 millimeters long. It allows optimal retention of tissue, for example the human shoulder tendon.

FIG. 2 shows a top view of the non-inventive embodiment variant shown in FIG. 1 of an implant IM with an outer edge 3 and an inner edge 4 . The circular perimeter of the clamping surface 1 allows its use for minimally invasive surgical interventions. In this top view of FIG. 2, the head 8 of the mounting means hides the opening 7 (not visible) of the implant IM.

The mounting means 2' are here designed as screws 11, which can be screwed into the bone using suitable special tools. This allows quick and easy introduction of the implant. At the same time, by screwing in the screw 11, the contact pressure of the clamping surface 1 against the tissue to be fixed can be flexibly changed and adjusted. The clamping surface 1 is perforated by means of connecting webs 5 and openings 14, also shown in FIG. blood flow, and the necrotic course is prevented.

Via the connecting web 5, a suitable holding or grasping device is possible to hold and optimally guide the implant IM during the surgical intervention. As a result, the implant can be introduced and anchored at a specific site within the bone.

FIG. 3 shows an embodiment variant of the implant IM with protrusions 15 in a perspective view from the underside of the implant. An implant IM for planar connection of tissue to bone comprises a clamping surface 1 with a lateral edge 3 and a medial edge 4 . The outer edge 3 is connected to the inner edge 4 by a connecting web 5 and the clamping surface 1 is provided with openings 14, 7'' arranged in the clamping surface 1, the openings 7'' being , is connected by a connecting web 5 to a partial area of the outer edge 3 .

The clamping surface 1 has an elliptical contour and a further opening 7'' is formed eccentrically in the clamping surface 1 for receiving the mounting means 2'. By this means it is possible to select the optimal position of the implant IM with respect to the tendon and the mounting means 2'. The mounting means 2 ′ comprise a pin 10 , a head 8 (not visible in this view) and a neck 9 .

The clamping surface 1 comprises a projection 15 which is offset with respect to the clamping surface 1, the projection 15 having openings 16, 19, the opening 19 in this projection being adapted for mounting means. 2″, the further opening 16 in this projection is designed as a cutout. The projections 15 are arranged along the lateral extent of the clamping surface 1 and are formed in one piece with the clamping surface 1 . In the interaction of the eccentrically arranged opening 7'' of the clamping surface 1 and the mounting means 2' a simple and rapid fixation of the implant IM to the bone is possible. A further opening 16 in this protrusion is designed as a cutout, allowing only a very small contact surface of the protrusion 15 to the tissue, the tissue being partially covered by the protrusion 15, thereby Additional openings 16 can positively affect oxygen supply or improve blood flow. Due to the fact that the projections 15 are offset, it is possible to prevent excessive contact pressure and consequent necrotic effects of the clamping surface 1 on the tendons to be held by the clamping surface 1. can.

FIG. 3 also shows that the clamping surface has two opposite spikes 17', 17'' formed on its underside, which spikes 17', 17'' , with returns. The pin 10 of the mounting means 2', 2'' is constructed in the form of a sleeve, in the manner of a drive sleeve, and is likewise provided with barbs. This type of shaping allows a simple driving of the mounting means 2'' into the bone and a mounting of the mounting means against inadvertent detachment.

Furthermore, FIG. 3 illustrates that the clamping surface is provided with a plurality of fastening means 6′, 6″, 6″″, 6″″, these fastening means being , is integrally formed of the same material under the clamping surface 1, perpendicular to the clamping surface 1, and has a conical shape and a high areal density.

Furthermore, the mounting means of the clamping surface 1 and the mounting means 2'' of the projection are arranged parallel to each other and have different lengths, and that the clamping surface 1 forms a plane. , the mounting means 2' of the clamping surface are arranged perpendicularly to said plane.

List of reference signs:
IM... Implant, 1... Clamping surface, 2'... Mounting means (clamping surface), 2''... Mounting means (protrusion), 3... Edge (outer), 4... Edge (inner), 5... Connecting web, 6' to 6''''... fixing means, 7'... opening (center), 7''... opening (eccentric), 8... head, 9... neck, 10... pin, 11... screw, 12 ... longitudinal axis of the pin, 14 ... opening, 15 ... projection, 16 ... opening (further projection), 17', 17'' ... spike, 18 ... instrument engaging opening, 19 ... opening ( protrusion).

Claims (17)

An implant (IM) for planar connection of tissue to bone, said implant (IM) comprising a clamping surface (1),
said clamping surface (1) comprises an outer edge (3) and an inner edge (4),
said outer edge (3) is at least partially connected to said inner edge (4) by at least partially at least one connecting web (5);
and/or
said clamping surface (1) comprising an outer edge (3) and at least one opening (14) located within said clamping surface (1);
an implant (IM), wherein said opening (14) is connected by at least one connecting web (5) to at least a partial area of said outer edge (3) of said clamping surface (1), ,
said clamping surface (1) has a circular, elliptical or polygonal perimeter, in particular a contour with rotational and/or mirror symmetry,
Said clamping surface (1) has a further opening (7', 7''), said further opening (7', 7'') for receiving a mounting means (2'). Implant (IM), designed, characterized in that said mounting means (2') comprise a pin, a head and a neck. Implant (IM) according to claim 1, characterized in that said further opening (7') in said clamping surface (1) is centered. At least one of the preceding claims, characterized in that said further opening (7', 7'') has a cavity for receiving said head (8) in a form-fitting manner. Implant (IM) described in 1. characterized in that said neck (9) and said head (8) together with said further openings (7', 7'') form a joint, in particular a joint in the manner of a wobble joint. Implant (IM) according to at least one of the preceding claims. The joint is such that the clamping surface (1) is between 0° and 65°, in particular between 0° and 55°, preferably 0°, relative to the axis defined by the longitudinal axis (12) of the pin. Implant (IM) according to at least one of the preceding claims, characterized in that it allows tilting only between 0° and 45°, particularly preferably between 0° and 20°. . Implant (IM) according to at least one of the preceding claims, characterized in that said further opening (7'') in said clamping surface (1) is eccentric. Said clamping surface (1) comprises at least one protrusion (15), said protrusion (15) being offset with respect to said clamping surface (1), said protrusion (15) being , having at least one opening (16, 19), said opening (19) in said projection being designed for receiving mounting means (2''), Implant (IM) according to at least one of the preceding claims, characterized in that the further opening (16) is designed as a cutout. Said clamping surface (1) comprises at least two opposite spikes (17', 17''), said spikes (17', 17'') extending below said clamping surface (1). and/or characterized in that said spikes (17', 17'') are preferably provided with barbs. plant (IM). Implant (IM) according to at least one of the preceding claims, characterized in that said pin (10) comprises a thread. A prior art device characterized in that said pin (10) is configured in the form of a sleeve, in particular in the manner of a drive sleeve, and/or that said pin (10) is provided with barbs. Implant (IM) according to at least one of the preceding claims. Said clamping surface (1) comprises a plurality of fixing means (6', 6'', 6'''', 6''''), said fixing means (6', 6'', 6'') ', 6'''') are formed on the underside of the clamping surface (1), in particular perpendicular to the clamping surface (1). Implant (IM) as described in at least one of the above. said fixing means (6', 6'', 6'''', 6'''') being integrally formed of the same material on said clamping surface (1) and/or said The fixing means (6', 6'', 6'''', 6'''') are conical and/or the fixing means (6', 6'', 6'''', 6 Implant (IM) according to at least one of the preceding claims, characterized in that the '''') has a high areal density. said fixing means (6', 6'', 6'''', 6'''') are formed with a length greater than 2 mm, preferably between 2 mm and 6 mm; and/or said length of said fixing means (6′, 6″, 6″″, 6″″) increases towards said outer edge of said clamping surface (1). Implant (IM) according to at least one of the preceding claims, characterized in that it At least two mounting means (2', 2'') are arranged substantially parallel to each other and/or have different lengths and/or the clamping surface (1) is forming a plane, at least one mounting means (2', 2'') being arranged substantially perpendicular to said plane and/or at least one mounting means (2', 2' ') are arranged substantially parallel to said plane. CHARACTERIZED IN THAT said clamping surface (1) comprises an instrument engaging surface and/or an instrument engaging opening (18), said instrument engaging surface being free of fixing means. , an implant (IM) according to at least one of the preceding claims. Said at least one projection (15) is arranged substantially along the lateral extent of said clamping surface (1) and/or said at least one projection (15) and said clamping surface (1) ) is formed in one piece. At least one of the preceding claims, characterized in that said clamping surface (1) has at least partially rounded edges and/or is at least partially curved. Implant (IM) described in one.

Images